Figure 7
Schematic representation of the RT-PK phenomenon of sorafenib. When the liver is irradiated concurrently with sorafenib administration, the activity of P-gp is upregulated to increase efflux activity and to intensify the recycling and enterohepatic circulation of sorafenib, which in turn increases the AUC of sorafenib. In contrast, the sequential RT regimen increases the expression of CYP3A4, which increases the oxidative metabolism of sorafenib. Additionally, compared with sorafenib alone, RT9Gy increased the AUC twofold; thus, SBRT is more efficient than the conventional RT technique to increase the rate of recanalization in HCC patients with PVTT under treatment with RT and sorafenib.
